Provider Demographics
NPI:1225568330
Name:FMUC, PLLC
Entity type:Organization
Organization Name:FMUC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIBETH
Authorized Official - Middle Name:K
Authorized Official - Last Name:PENARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-264-1830
Mailing Address - Street 1:6000 NORTHERN PASS DR STE A100
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79911-7207
Mailing Address - Country:US
Mailing Address - Phone:915-264-1830
Mailing Address - Fax:915-264-1830
Practice Address - Street 1:6000 NORTHERN PASS DR STE A100
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79911-7207
Practice Address - Country:US
Practice Address - Phone:915-264-1830
Practice Address - Fax:915-264-1840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8245207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty